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Immunoregulatory Effects of Immunoglobulin Induction Therapy in Renal Transplant Recipients

Early Phase 1
Completed
Conditions
Renal Failure, Chronic
Renal Transplantation
Registration Number
NCT00176059
Lead Sponsor
University of Giessen
Brief Summary

The aim of this randomized prospective study in renal transplant recipients is to investigate immunological short and long-term effects of an IVIG induction therapy.

Furthermore clinical endpoints (patient and graft survival, incidence of acute and chronic rejection, infectious diseases and graft function) up to three years posttransplant will be analyzed.

Detailed Description

Intravenous immunoglobulin (IVIG) preparations are known to be effective in the treatment of various autoimmune and inflammatory disorders due to their immunomodulatory and antiinflammatory properties. It has been demonstrated that IVIG is effective in the treatment of acute vascular rejection and steroid resistant cellular rejection. Furthermore, IVIG has been used to inhibit production of lymphocytotoxic antibodies in highly sensitized patients so that successful cadaveric or living renal transplantation could be performed.

The aim of this randomized prospective study in renal transplant recipients is to investigate immunological short and long-term effects of an IVIG induction therapy on Th1, Th2 and B-cell/monocyte responses, expression of adhesion molecules, costimulatory factors and cytokine receptors and on secretion of immunoregulatory autoantibodies (anti-F(ab)-, anti-F(ab')2G-, anti-hinge autoantibodies). These autoantibodies have been shown to significantly affect the risk of chronic rejection and graft loss.

Furthermore, clinical endpoints (patient and gaft survival, incidence of acute and chronic rejection, infectious diseases and graft function) up to 3 years will be analyzed.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
50
Inclusion Criteria
  • renal transplant recipients of the Giessen renal transplant unit
  • cadaveric and living renal transplants
  • first and retransplants
Exclusion Criteria
  • Contraindications against blood-taking (anaemia with hemoglobin < 9,5 g/l, hypotension)
  • intravenous immunoglobulin therapy in the last half year before study entry
  • Hyperimmunoglobulin therapy for severe CMV infection
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
patient survival1 year / 3 years / 5 years posttransplant
graft survival1 year / 3 years / 5 years posttransplant
acute rejection1 year
chronic allograft nephropathy3 years / 5 years posttransplant
Secondary Outcome Measures
NameTimeMethod
graft function1 year / 3 years / 5 years
infectious complications1 year
immunoglobulin levels1 year
regulatory autoantibody levels1 year / 3 years / 5 years
Th1 and Th2 responses1 year / 3 years
B-cell/monocyte responses1 year / 3 years
Expression of adhesion molecules, costimulatory molecules and cytokine receptors1 year / 3 years
proteinuria (quantitative assessment)1 year / 3 years

Trial Locations

Locations (1)

Department of Internal Medicine, University of Giessen

🇩🇪

Giessen, Germany

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